Novel biomarkers for cardiovascular risk prediction

Juan WANG; Guo-Juan TAN; Li-Na HAN; Yong-Yi BAI; Miao HE; Hong-Bin LIU

doi:10.11909/j.issn.1671-5411.2017.02.008

摘要：Cardiovascular disease (CVD) is the leading cause of death and disability worldwide.The primary prevention of CVD is dependent upon the ability to identify high-risk individuals long before the development of overt events.This highlights the need for accurate risk stratification.An increasing number of novel biomarkers have been identified to predict cardiovascular events.Biomarkers play a critical role in the definition,prognostication,and decision-making regarding the management of cardiovascular events.This review focuses on a variety of promising biomarkers that provide diagnostic and prognostic information.The myocardial tissue-specific biomarker cardiac troponin,highsensitivity assays for cardiac troponin,and heart-type fatty acid binding proteinall help diagnose myocardial infarction (MI) in the early hours following symptoms.Inflammatory markers such as growth differentiation factor-15,high-sensitivity C-reactive protein,fibrinogen,and uric acid predict MI and death.Pregnancy-associated plasma protein A,myeloperoxidase,and matrix metalloproteinases predict the risk of acute coronary syndrome.Lipoprotein-associated phospholipase A2 and secretory phospholipase A2 predict incident and recurrent cardiovascular events.Finally,elevated natriuretic peptides,ST2,endothelin-1,mid-regioual-pro-adrenomedullin,copeptin,and galectin-3 have all been well validated to predict death and heart failure following a MI and provide risk stratification information for heart failure.Rapidly developing new areas,such as assessment of micro-RNA,are also explored.All the biomarkers reflect different aspects of the development of atherosclerosis.